Effects of pimobendan on left atrial transport function in cats

Abstract

Background: Arterial thromboembolism is a sequela of hypertrophic cardiomyopathy (HCM) in cats related to left atrial (LA) enlargement and dysfunction. Hypothesis: Pimobendan improves LA transport function in cats. Animals: Twenty-two client-owned cats with HCM and 11 healthy cats. Methods: Prospective, double-blind, randomized, placebo-controlled clinical cohort study. Cats were randomized to receive either pimobendan (0.25 mg/kg PO q12h) or placebo for 4 to 7 days. Nineteen echocardiographic variables of LA size and function were evaluated. Statistical comparisons included t tests, analysis of variance, and multivariable analyses. Results: Peak velocity of left auricular appendage flow (LAapp peak; mean ± SD, 0.85 ± 0.20 vs 0.71 ± 0.22 m/s; P =.01), maximum LA volume (P =.03), LA total emptying volume (P =.03), peak velocity of late diastolic transmitral flow (A peak velocity; 0.77 ± 0.12 vs 0.62 ± 0.17 m/s; P =.05), and A velocity time integral (A VTI; 3.05 ± 0.69 vs 3.37 ± 0.49; P =.05) were increased after pimobendan. Mean change after pimobendan was larger in cats with HCM compared to healthy cats for LA fractional shortening (2.1% vs −2.1%; P =.05), A VTI (0.58 vs 0.01 cm; P =.01), LAapp peak (0.20 vs 0.02 m/s; P =.02), LA kinetic energy (3.51 vs −0.10 kdynes-cm; P =.05), and LA ejection force (1.93 vs −0.07 kdynes; P =.01) in the multivariable model. The stronger effect of pimobendan in cats with HCM was independent of LA size. Conclusions and Clinical Importance: We identified positive, albeit minor, effects of pimobendan on LA function in cats with HCM. Whether or not treatment with pimobendan decreases the risk of cardiogenic embolism deserves further study.